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Ferrera G, D'Alessandro S, Cuccia F, et al. Post-operative hypofractionated radiotherapy for prostate cancer: a mono-institutional analysis of toxicity and clinical outcomes. J Cancer Res Clin Oncol. 2021;148(1):89-95doi: 10.1007/s00432-021-03816-y.
Ferrera, G., D'Alessandro, S., Cuccia, F., Serretta, V., Trapani, G., Savoca, G., Mortellaro, G., & Lo Casto, A. (2022). Post-operative hypofractionated radiotherapy for prostate cancer: a mono-institutional analysis of toxicity and clinical outcomes. Journal of cancer research and clinical oncology, 148(1), 89-95. https://doi.org/10.1007/s00432-021-03816-y
Ferrera, Giuseppe, et al. "Post-operative hypofractionated radiotherapy for prostate cancer: a mono-institutional analysis of toxicity and clinical outcomes." Journal of cancer research and clinical oncology vol. 148,1 (2022): 89-95. doi: https://doi.org/10.1007/s00432-021-03816-y
Ferrera G, D'Alessandro S, Cuccia F, Serretta V, Trapani G, Savoca G, Mortellaro G, Lo Casto A. Post-operative hypofractionated radiotherapy for prostate cancer: a mono-institutional analysis of toxicity and clinical outcomes. J Cancer Res Clin Oncol. 2022 Jan;148(1):89-95. doi: 10.1007/s00432-021-03816-y. Epub 2021 Sep 30. PMID: 34595542.
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J Cancer Res Clin Oncol. 2022 Jan;148(1):89-95. doi: 10.1007/s00432-021-03816-y. Epub 2021 Sep 30.

Post-operative hypofractionated radiotherapy for prostate cancer: a mono-institutional analysis of toxicity and clinical outcomes.

Journal of cancer research and clinical oncology

Giuseppe Ferrera, Salvatore D'Alessandro, Francesco Cuccia, Vincenzo Serretta, Giovanna Trapani, Gianfranco Savoca, Gianluca Mortellaro, Antonio Lo Casto

Affiliations

  1. Radiotherapy Unit, ARNAS Civico Hospital, Palermo, Italy.
  2. Radiation Oncology School, University of Palermo, Palermo, Italy.
  3. Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy. [email protected].
  4. GSTU Foundation, La Maddalena Clinic for Cancer, Palermo, Italy.
  5. Urology Unit, ARNAS Civico Hospital, Palermo, Italy.
  6. Biomedicine, Neuroscience and Advanced Diagnostic Department Bi.N.D., Institute of Radiology, University of Palermo, Palermo, Italy.

PMID: 34595542 DOI: 10.1007/s00432-021-03816-y

Abstract

BACKGROUND: As the use of hypofractionation has spread in the setting of curative prostate radiotherapy, few data are available in the post-operative scenario. This study reports a mono-institutional experience of moderate post-operative hypofractionated radiotherapy for prostate cancer.

METHODS: In February 2021, we retrospectively assessed the outcomes of 129 patients who received between April 2013 and May 2020 hypofractionated post-operative radiotherapy using Helical Tomotherapy. Toxicity was assessed using CTCAE criteria v4.0. Survival endpoints were calculated with Kaplan-Meier method.

RESULTS: Median age and follow-up were, respectively, 67 years and 43 months. Adjuvant and salvage treatment were delivered to 63.5% and 36.4% of patients to a median total dose of 63.8 Gy (61.6-65.25 Gy) in 29 fractions (2.12-2.25 Gy/fraction). Pelvic lymph-nodes irradiation was performed in 67.4% of cases. ADT was added in 50%. Acute toxicity was: G1 and G2 GU events in 36% and 9.3% of cases; G1 and G2 GI events in 29.4% and 13.9%. Late GU toxicity occurred in 12.4% of cases: 3.1% G1, 7.7% G2 and 1.5% G3 events; GI toxicity consisted of 1.5% G1 and 7.7% G2 events. Biochemical relapse occurred in 26.3% of cases, recording no significant differences between adjuvant and salvage (p = 0.67), with 4- and 5-years bRFS rates of 78.7% and 75.6%. Two patients died of progressive disease and eight for non-oncological causes resulting in 3-years overall survival and cancer-specific survival rates of 98% and 98.4%.

CONCLUSIONS: Our experience supports the use of moderate hypofractionation for prostate bed radiotherapy, with minimal toxicity and promising results in terms of clinical outcomes.

© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Keywords: Hypofractionation; Post-operative; Prostate cancer; Radiotherapy

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